Indigent Care Trust Fund

Overview

The Indigent Care Trust Fund (ICTF) was established by law in 1990 as a separate fund in the State Treasury. The trust fund itself is composed of discrete program accounts. The ICTF is administered by the Department of Community Health (DCH, Department).

The purpose of the ICTF is to:

Expand Medicaid eligibility and services; and

Support rural and other care providers (primarily hospitals) who serve the medically indigent; and,
Support primary health care programs for medically indigent citizens of Georgia.

ICTF is funded by a combination of state appropriations, provider fees and payments, breast cancer automobile tag fees, voluntary intergovernmental transfers, federal funds, ambulance licensing fees, and Certificate of Need (CON) penalties.

Indigent Care Trust Fund Programs

Disproportionate Share Hospital (DSH) is a federal program that seeks to increase health care access for the medically indigent. DSH payments are distributed based upon each hospital’s uncompensated cost of services provided to Medicaid patients and the uninsured. More than 100 Georgia hospitals qualify annually for DSH payments.

Hospital Medicaid Financing Program was authorized by Senate Bill 24 (2013 Session of the Georgia General Assembly). Pursuant to SB 24, the DCH Board of Community Health assesses a provider fee on hospital net patient revenue and then uses these assessments to match federal Medicaid funds to support Georgia’s Medicaid program.

Nursing Home Provider Fee Program was authorized by the Georgia General Assembly in 2003. The statute establishes a nursing home provider fee that DCH uses to match federal Medicaid funds. The combined total of federal funds and provider fees is paid back to nursing home providers who disproportionately serve the medically indigent. This is accomplished through an increase in Medicaid benefit reimbursements to the nursing home.

Breast Cancer Automobile Tag Fees are used to fund cancer screening and treatment-related programs for those people who are medically indigent and who have or may have breast cancer.

Ambulance Licensing Fees are assessed by the Board of Public Health to all ambulance services in the state. DCH draws down the fees deposited into the ICTF to match additional federal Medicaid dollars to fund Medicaid benefit payments for ambulance services.

DSH Audit Redistribution 2018-2019 - Memorandum - Posted 04/04/23